Liver and Bile
J Gastroenterol Hepatol. 2024;39(5):955–63
Statin use in cirrhosis and its association with incidence of portal vein thrombosis
Background and aim: Statin use has shown a reduction in hepatic decompensation and portal hypertension. Its association with portal vein thrombosis (PVT) incidence is unknown. The authors aim to compare the incidence of PVT in patients with and without statin use.
Methods: They excluded patients with a history of hepatocellular cancer, liver transplants, Budd-Chiari syndrome, and intra-abdominal malignancies. Patients with cirrhosis were followed from their first hepatologist clinical encounter (January 1, 2016, to January 31, 2021) for 180 days to determine PVT incidence. The association of statin use with PVT using 1:1 propensity score matching and Cox proportional hazard regression was tested.
Results: 2785 patients with cirrhosis (mean age, 61.0 ± 12.3 years, 44.3% female, 63.8% white, mean MELD-Na score, 11.7 ± 6.1, and statin use, 23.1%) were analyzed. A total of 89 patients developed PVT during the follow-up, which was lower in patients with statin use as compared to no statin use (1.3% vs. 3.8%, p = 0.001, unadjusted hazard ratio [HR] = 0.28, 95% confidence interval [CI]: 0.13–0.62, p = 0.001). After matching for demographics, comorbidities, and hepatic decompensation events, patients with statin use had a lower risk of developing PVT in 180-day follow-up as compared to those without statin use (HR = 0.24, 95% CI: 0.10–0.55, p = 0.001). Subgroup analysis showed that statin use was associated with lower PVT incidence in non-NASH (HR = 0.20, 95% CI: 0.07–0.54, p = 0.002) and decompensated cirrhosis (HR = 0.12, 95% CI: 0.03–0.53, p = 0.005) than no statin use.
Conclusion: Portal vein thrombosis incidence was lower in decompensated cirrhosis patients with statin use than in those with no statin use. However, this finding needs to be further tested in randomized controlled trials.
DOI: 10.1111/jgh.16495